Diagnosis and treatment of melamine-associated urinary calculus complicated with acute renal failure in infants and young children

Background Infants in some areas of China developed urinary lithiasis after being fed with powdered milk that was tainted with melamine in 2008 and very small proportion of the infants developed acute renal failure caused by urinary tract calculus obstruction. The aim of this article was to summariz...

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Published in:Chinese medical journal 2009-02, Vol.122 (3), p.245-251
Main Authors: Sun, Ning, Shen, Ying, Sun, Qiang, Li, Xu-ran, Jia, Li-qun, Zhang, Gui-ju, Zhang, Wei-ping, Chen, Zhi, Fan, Jian-feng, Jiang, Ye-ping, Feng, Dong-chuan, Zhang, Rui-feng, Zhu, Xiao-yu, Xiao, Hong-zhan
Format: Article
Language:English
Subjects:
Acute Kidney Injury - diagnosis
Acute Kidney Injury - etiology
Acute Kidney Injury - pathology
Acute Kidney Injury - therapy
Child, Preschool
Cystoscopy
Female
Humans
Infant
Male
Peritoneal Dialysis
Retrospective Studies
Treatment Outcome
Triazines - poisoning
Urinary Calculi - complications
Urinary Calculi - diagnosis
Urinary Calculi - pathology
Urinary Calculi - therapy
婴幼儿
急性肾功能衰竭
治疗方法
泌尿系结石
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Summary:Background Infants in some areas of China developed urinary lithiasis after being fed with powdered milk that was tainted with melamine in 2008 and very small proportion of the infants developed acute renal failure caused by urinary tract calculus obstruction. The aim of this article was to summarize clinical characteristics, diagnosis and treatment of infants with urinary calculus and acute renal failure developed after being fed with melamine tainted formula milk. Methods Data of infant patients with urinary calculus and acute renal failure due to melamine tainted formula milk admitted to the Beijing Children＇s Hospital Affiliated to the Capital Medical University and the Xuzhou Children＇s Hospital in 2008 were used to analyze the epidemiological characteristics, clinical manifestations, imaging features as well as effects of 4 types of therapies. Results All the 34 infants with urinary calculus were complicated with acute renal failure, their blood urea nitrogen （BUN） was （24.1±8.2） mmol/L and creatinine （Cr） was （384.2±201.2） umol/L. The chemical analysis on the urinary calculus sampled from 15 of the infants showed that the calculus contained melamine and acidum uricum. The time needed for the four types of therapies for returning Cr to normal was （3.5±1.9） days for cystoscopy group, （2.7±1.1） days for lithotomy group, （3.8±2.3） days for dialysis group, and （2.7±1.6） days for medical treatment group, which had no statistically significant difference （P=-0.508）. Renal failure of all the 34 infants was relieved within 1 to 7 days, averaging （3.00±1.78） days. Conclusions Melamine tainted formula milk may cause urinary calculus and obstructive acute renal failure. It is suggested that firstly the patients with urinary calculus complicated with acute renal failure should be treated with dialysis or medication to correct electrolyte disturbance, in particular hyperkalemia, and then relieve the obstruction with available medical and surgical methods as soon as possible. It was observed that the short-term prognosis was satisfactory.
ISSN:0366-6999
2542-5641
DOI:10.3760/cma.j.issn.0366-6999.2009.03.002